March 14, 2007
Hypoglycemia
Question from Churchton, Maryland, USA:
I have a six-year-old who has been diagnosed with hypoglycemia. He has regular episodes and we are now doing glucose tests four times a day. What are the resources available for us? Do we use the diabetic support lines? I have been advised by a nutritionist and a pediatrician to treat him as a diabetic, but the endocrinologist seems very lax about treatment plans. We are concerned both for his health and also for future development of type 1 diabetes. I also wonder how many children with diabetes have started with hypoglycemia before being diagnosed. We have a very strong family history of diabetes, types 1 and 2. My son also has had a great deal of steroids in his young life and we now hear that there is a connection between type 1 diabetes and steroid medications. How much information is available on this subject?
Answer:
Your last question is probably the easiest to answer. The early steroid treatment is not so much a factor now as long as it is not continuing. About 5 to 10% of kids with type 1 diabetes seem to have, in retrospect, in some research studies, something that historically sounds like they could have had hypoglycemia. We assume that this represents some overproduction of insulin intermittently in the stage where the pancreas is “dying.” If you still have some concerns, it would be prudent to seek a second opinion from another pediatric diabetologist and also to request that your pediatrician speak directly with the current pediatric endocrinologist so that they can decide what else might need to be done, how to monitor, what type of nutrition planning, follow-up, etc. and give you consistent recommendations.
SB
